Labour and birth with type 1 or 2 diabetes

Labour and birth may be different from what you had imagined, but it can still be a positive experience. Talk to your healthcare team about what your options are.

Planning the birth

Although many women with type 1 or 2 diabetes have a healthy birth, there are some risks associated with giving birth if you have diabetes.

You will be advised to give birth early to reduce the risk of stillbirth. This will usually be during week 37 or week 38 of your pregnancy. You may be advised to have your baby earlier than this if you have complications, such as high blood pressure or if your baby’s growth has slowed down.  

If your ultrasound scans have shown that your baby is large, you may be advised to have an induction (bringing labour on earlier) or planned caesarean section. You may still be able to give birth vaginally if you want to, even if you’ve had a caesarean section before.

Your healthcare team should explain your options for giving birth before you make your birth plan. It’s important that you understand the advantages and disadvantages of every option, so you can make an informed decision about what you want. Don’t be afraid to ask questions.

Where to have your baby

Ultimately, where you give birth is your decision. However, your team will advise you to give birth in a hospital, because it has all the facilities needed to look after you and your baby during and after labour.

Pain relief

If you have other issues affecting your health, such as being overweight or any spinal nerve‑related problems, you may be advised to see an anaesthetist. They can talk to you about the best method of pain relief during the birth.

If your labour starts before 37 weeks

If you go into labour early, you may also be given steroids to help your baby’s lungs develop. If you’re on insulin, steroids may affect your glucose levels and you may need to increase your insulin dose. Your healthcare team will talk to you about this if your labour starts early.

Be flexible

Like all pregnancies, sometimes things don’t go according to plan during pregnancy or labour. You will need to be flexible and adaptable as labour progresses. Your maternity team should involve you (or your birth partner if necessary) in any decisions that need to be made to make sure your baby is delivered safely.

"I'd tried my best to avoid a c-section but I ended up having an emergency c-section – and it had nothing to do with the diabetes. I was sad, but mostly I was just glad that she was healthy."
Maria

Your glucose levels during labour and birth

It’s good to keep your glucose level as stable as possible during labour. It is thought that this will help to prevent your baby’s glucose from going low after they are born. This is known as neonatal hypoglycaemia. Your glucose level will be measured regularly throughout labour.

If your glucose levels are not kept stable, you may be given insulin and glucose through a drip to help. If you have type 1 diabetes, you may be offered an insulin and glucose drip from the start of established labour. Established labour is when your cervix opens (dilates) to at least 4cm and your contractions become stronger and more regular.

If you are using pump therapy, you should be able to use your pump during labour if you want to. You or perhaps your partner may find it easier to manage your glucose levels using your pump, rather than switching to an insulin drip.

'I was told that I’d be taken off the pump when I was ready for the healthcare team to take over. But I stayed in control of it until about an hour before I gave birth, and I went back on it an hour or two after the birth.' 

Zoe

After the birth

You should be able to hold your baby immediately after they are born. They will be able to stay with you unless they need extra care. Find out more about your baby after giving birth with type 1 or 2 diabetes.

You will be encouraged to feed your baby as soon as you can (within 30 minutes) to help keep your baby’s glucose levels stable. It’s important to monitor your glucose levels regularly when you’re breastfeeding. If your glucose levels are too low, you could have a hypoglycaemic episode while you’re feeding.

Find out more about feeding your baby after birth with type 1 or 2 diabetes.

Your care after the birth

The most important thing is to avoid low glucose levels after your baby is born.

If you used insulin during your pregnancy, you should expect to dramatically reduce or even stop the amount you are taking straight after the birth. Often you won’t need insulin with your first light meal.

You should also check your glucose levels regularly until you are comfortable that you are taking the right dose. This is because your body needs less insulin to manage your glucose levels after your baby is born. Your care team will help you with this.

If you have type 2 diabetes and started insulin during your pregnancy, you may be able to return to the treatment that you were on before getting pregnant. If you decide to breastfeed, your healthcare team will talk to you about which options are safe.  

Find out more about your care after the birth.

If you’re breastfeeding

It’s important to monitor your glucose levels regularly when you’re breastfeeding. If your glucose levels are too low, you could have a hypoglycaemic episode while you’re feeding.

Read more about feeding your baby with type 1 and type 2 diabetes.

 

Also in this section

More sections on type 1 or 2 diabetes and pregnancy

Sources

NICE (2015). Diabetes in pregnancy: management from preconception to the postnatal period. National Institute for health and care excellence https://www.nice.org.uk/guidance/ng3

Drever E et al. (2016) Insulin pump use compared with intravenous insulin during labour and delivery: the INSPIRED observational cohort study. Diabetic medicine: a journal of the British Diabetic Association 2016 Sep;33(9):1253-9. doi: 10.1111/dme.13106. Epub 2016 Mar 20.

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    Last reviewed on August 3rd, 2020. Next review date August 3rd, 2023.

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    Comments

    Please note that these comments are monitored but not answered by Tommy’s. Please call your GP or maternity unit if you have concerns about your health or your baby’s health.
    • By Hafsa (not verified) on 30 Mar 2020 - 18:54

      I am 32 weeks pregnant I gave birth three kids before two normal vaginal birth and one by c-section she was born at 34 week I was diabetic and same issue is now my question is can I give vaginal birth before due date as my last baby is four and half year old

    • By Anon (not verified) on 20 Jan 2020 - 19:47

      The Midwife’s would not allow me to use my pump therapy during my labour and sons birth at st Thomas even though diabetes drs during prenatal care said I could. Midwives said it was against their protocol and I had to use the drip. This is against the above and what the diabetes drs advised. I hope for subsequent births Im stronger to insist on staying on my pump

    • By Sahed (not verified) on 11 Jan 2019 - 13:08

      Can i have normal delivery during pregnancy of 8th month's by having diabetes

    • By Midwife @Tommys on 14 Jan 2019 - 09:35

      Diabetes should not prevent you from having a vaginal delivery. Your midwife will be keeping a close eye on your sugar levels during the labour and will give you insulin as required.

    • By tessa (not verified) on 11 Sep 2017 - 11:36

      I have had a stillbirth in July 2016 and miscarried in November the very year now I so want to be a parent bt at the same I hv fears my levels have been giving me a hard time every time I get pregnant

    • By Midwife @Tommys on 11 Sep 2017 - 12:46

      I am so sorry to hear of your loss - i hope you have had good care and support to help you during such a difficult time. Being worried about a future pregnancy is very understandable and a a normal reaction after a miscarriage. You may find the information we have on our website regarding life after a miscarriage useful:
      https://www.tommys.org/pregnancy-information/pregnancy-complications/pregnancy-loss/miscarriage/after-miscarriage
      Alternatively you can call us on 08000147800 or email us at [email protected] for any support or advice.

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